Office Procedures

Office Procedures

Thanks to new technologies and techniques, physicians can now perform various gynecologic procedures without incisions, avoiding scarring and minimizing pain and discomfort. Our office is equipped with ultrasound for procedures that require the technology and staff is trained in conscious sedation. After a short recovery time, patients can return to their daily activities.

Our highly trained gynecologists specialize in the following procedures:

Diagnostic and Therapeutic Hysteroscopy

Diagnostic hysteroscopy is used to examine the cervix and the lining of the uterus (endometrium).

A woman may need diagnostic hysteroscopy if she is experiencing:

  • Heavy, prolonged, or irregular menstruation
  • Bleeding after menopause
  • Bleeding due to hormone therapy
  • Difficulty getting pregnant

A physician may also request diagnostic hysteroscopy if:

  • An ultrasound revealed that the lining of a woman’s uterus is thicker than normal
  • A tissue sample is needed to check for abnormal cells that may be cancerous
  • Hysteroscopy is used to perform endometrial biopsies and polypectomies.

During an endometrial biopsy a tissue sample is taken from the lining of the uterus. The sample is later examined for any abnormal cells or signs of cancer. This procedure may be done with or without anesthesia.

Polypectomy is a procedure used to remove polyps that may be the cause of abnormal bleeding. The ultimate goal of the procedure is to stop abnormal bleeding and to inspect the tissue removed to rule out the presence of cancer.

Treatment for Abnormal Uterine Bleeding

Endometrial ablation is a procedure that destroys (ablates) the uterine lining, or endometrium. This procedure is used to treat dysfunctional or abnormal uterine bleeding. Sometimes a lighted viewing instrument (hysteroscope) is used to see inside the uterus.

Ablation is performed in the doctor’s office using a special balloon catheter which is inflated with hot water. The water is circulated around inside the balloon and never touches the patient. The heat destroys the lining of the uterus (endometrium), but does not damage the rest of the uterus. After an eight-minute treatment cycle, the catheter is removed and nothing is left behind in the uterus.

Hysteroscopic Sterilization (Essure)

Hysteroscopic Sterilization (Essure) is a form of permanent birth control in which the fallopian tubes are blocked using a natural barrier.

Essure does not require cutting into the body or the use of radiofrequency energy to burn the fallopian tubes. Instead, the physician inserts soft, flexible inserts through the body’s natural pathways (vagina, cervix, and uterus) and into the fallopian tubes. The very tip of the device remains outside the fallopian tube, which provides the woman and the doctor with immediate visual confirmation of placement.

During the three months following the procedure, the body and the inserts work together to form a natural barrier that prevents sperm from reaching the egg. During this period, a woman must continue using another form of birth control (other than an IUD).

After three months, the physician performs a confirmation test in which a dye and special type of X-ray are used to ensure that the inserts are in place and that the fallopian tubes are completely blocked.

Unlike birth control pills, patches, rings, and some forms of IUDs, Essure does not contain hormones to interfere with the natural menstrual cycle. A woman’s periods should more or less continue in their natural state.

Vulvar Procedures

A number of different procedures are offered for the diagnosis and treatment of vulval conditions such as vulvodynia, vaginismis and lichen sclerosis.

A partial hymenectomy may be recommended in certain cases of chronic vulval pain (vulvodynia) or vulval vestibulitis, redness and inflammation near the opening of the vagina. Conscious sedation is combined with local anesthesia and then the over sensitive areas of hymenal skin are identified and surgically excised. Small absorbable sutures are placed as needed.

Labiaplasty

Labiaplasty is a cosmetic reduction of abnormally enlarged labia. This procedure is performed for a variety of reasons, including correction of damage done to the labia during childbirth, or for aesthetic reasons. Conscious sedation is combined with local anesthesia. Redundant, scarred or torn labial tissue is surgically removed and incisions are closed with small absorbable sutures.

Removal of Vulvar Warts with Electrocautery

Electrocautery removes genital warts on the vulva or around the anus by burning them with a low-voltage electrified probe.
A local anesthetic is usually used for pain control, however if the warts are extensive, a general anesthetic may be advised.

LEEP (Loop Electrosurgical Excision Procedure)

Loop Electrosurgical Excision Procedure (LEEP) is used to treat pre-cancerous conditions (cervical dysplasia) on the cervix. LEEP is used after abnormal Pap results have been confirmed by colposcopy and cervical biopsy. Tissue removed during the procedure will be sent for histological examination.

Local anesthesia on the cervix is used in this procedure. LEEP uses a thin wire loop electrode which is attached to an electrosurgical generator. The generator transmits a painless electrical current that quickly cuts away the affected cervical tissue in the immediate area of the loop wire. This causes the abnormal cells to rapidly heat and burst, and separates the tissue as the loop wire moves through the cervix.

This technique allows the physician to send the excised tissue to the lab for further evaluation, which ensures that the lesion was completely removed, as well as allowing for a more accurate assessment of the abnormal area.

Removal of Moles or Pigmented Lesions

Excisional biopsy of the lesion is done under local anesthesia. The tissue is then sent for a histological evaluation.